Whole Foods is known for its comprehensive benefits package. This offer is an incentive for employees to be more healthy thereby lowering Whole Foods' health care costs. Having biometric records will allow them to justify lower costs to their insurers.

I don't disagree with anything in the post. I'm just pointing out their policy is perfectly rational. Even if BMI isn't related to health, insurers perceive it to be, so it's still related to Whole Foods' costs.

With the government planning regulate and subsidize health care I'm sure we can look forward to this kind of thing on an even larger and more invasive scale.

This is kinda old. In fact, Oregon (I believe it's Oregon) is already taking steps in questioning the discriminatory nature of this Health Incentive Discount thing, citing that people with certain diseases or disabilities may never qualify for higher than their usual 20%. (Although I tend to agree with George up there in saying that this is probably purely about insurance, whether right or wrong.)

North Carolina's state health plan penalizes high-BMI and smoking workers by denying them access to the better health plan. Same idea - health risks lead to denial of health service. Shape up or ship out. http://www.newsobserver.com/news/health_science/story/129651.html

Actually, someone with a BMI or 30 or over wouldn't qualify for bronze... they wouldn't qualify for anything. (BMI between 28 and 30 is "bronze level.")

Why doesn't anyone understand that shame does not make people thin? I ranted about this on my own blog a few days back (http://dimethirwen.livejournal.com/732833.html) - this system makes no logical sense, and only contributes to a larger problem. The number one reason being overweight isn't healthy has nothing to do with heart disease or diabetes, but rather the fact that people as little as 13 pounds "overweight" are less likely to seek medical help because of shame and fatphobia.

Every time I go to the doctor for anything - most recently, a cough that persisted after I had swine flu - they try to link it back to my weight. Ask anyone who is even slightly overweight how often their doctor suggests that their medical problem (which, 90% of the time, is unrelated to their size) has to do with their weight?

This program is so stupid and shortsighted it's staggering.

Of course, using BMI means that people should NOT work out to have higher muscle-mass. If you run the BMI calculation for an athlete (one can easily find values online) or for a friend of yours who is athletic, you will see that they are more likely-than-not in a higher-than-expected category.

For example, Ryan Reynolds - 6'3", 200 lbs - is just overweight with a BMI of 25. (He qualifies for "Gold", but can't hang a Platinum on those washboard abs.)

As another example, Dwayne Johnson (aka The Rock) is 6'4", 260 lbs - falling into the obese category of BMI with a 31.6. Now there's a guy who needs to lose some of that pudge! (Dwayne doesn't qualify for any discount! He must be SO unhealthy. I mean, who would ever think that anyone could think of him as being physically healthy.)

Using a female athlete example, Serena Williams is 5'9", 175 lbs, which means that like Mr. Reynolds, she is overweight, with a BMI of 25.8. (Similar to Mr. Reynolds, Ms. Williams would only qualify for "Gold." Good thing she wasn't 176 lbs, because then she would have a BMI of 26, and therefor only be qualified for a Silver.)

Are really athletic people really a good group of people to look at when using BMI as a metric for general health? NO~~! Because BMI is a relationship between weight and height, and since muscle is more dense than fat, athletic people have high BMIs. It especially doesn't work well for tall athletes: Michael Phelps - 6'4", 200 lbs - is barely normal weight, with a BMI of 24.3, but even HE won't qualify for Platinum.

I personally think that Whole Foods can do whatever they want with their own benefits packages. However, this particular metric seems to unfairly discriminate against athletic people and even more so against tall athletic people.

I would imagine because BMI works on only on weight and height, that this doesn't really give any benefit to:

* women (physiologically higher levels of adipose)
* tall people and short people (i.e., those not a part of the group originally sampled to create BMI)
* those with longer than average torsos (body trunk weights more than legs)
* athletes/muscled people (muscle weighs more than fat)
* people with metal bone replacement (metal weighs more than bone)

Interestingly, an amputee would have a lower BMI than before becoming an amputee... (So in an extreme condition, amputation would lead to financial savings... but this is just a stray thought of mine...)

Similarly, if a significant amount of weight were water weight, then taking a steam bath or sauna, fully evacuating your bowels, getting a colonic, and not drinking anything (i.e., leaving you in that not-too-healthy condition of dehydration) prior to getting measured could mean that you could lose enough to drop you between categories. Talk about perverse incentives!

Why are Shapely Prose and Kate Harding so often referenced on this site? Shapely Prose is the site where a regular contributor wrote, "Even if the people who squeal about how it’s as simple as eating fewer calories than you expend were right about how the body works, what they’re suggesting would be absurd." http://kateharding.net/2008/07/17/what-if-they-were-right-about-calories

I also recall that they claimed that when Michael Phelps eats 10,000 calories a day during training, those calories are magically expended or translated into muscle, because of his "genetics"...and not because of his intense exercise regimen. And that, because Phelps is capable of breaking Olympic records on this diet, his diet is appropriate for everyone--regardless of activity level. Unfortunately, I can't find this post through Google.

Perhaps Shapely Prose offers the occasional good insight into the social issue of fat. But they spend an awful lot of time using pseudoscience in an attempt to debunk the science of how the body works.

Even if BMI on a population level - for some populations - reflects average health in some ways, it isn't going to work at the individual level to indicate irresponsible behavior, so it's not fair. I guess the only alternative is to haul all the employees into an independent doctor's office, and have the doctor evaluate the extent to which their bad behavior is negatively affecting their health. Then they could be punished appropriately.

(Or you could just have universal health care and use public education, product regulation and labeling to improve population health.)

http://lefarkins.blogspot.com/2010/01/whole-foods-junk-science-healthism-and.html

I'm not American, so I've always been shocked at the amount of intrusion my American friends take as normal. I remember someone telling me how their office had computer technology that monitored every keystroke to check that they were working in office hours and not checking facebook or whateverno - when I expressed how appalled I was, she responded, "Oh it's good, because I know that everyone in the office is pulling their weight." I also found it mind boggling how drug testing was just accepted as a prerequisite for getting a job. So the idea that added to that now your workplace can police your body is just horrifying to me.

And do we honestly believe that this information would just be private, that it will only be used for this particular discount, that other employers can't use this as precedent for much more serious testing, and that the intrusion would be limited only to smoking and BMI (if they're testing for nicotine, what's stopping them for testing, for example, for anti-depressants or other medications that might lead to stigmatization of the mentally ill?) Just wait for someone to get in a labour dispute and find their medical information mysteriously leaked that shows they were taking anxiety medication, or medication for schizophrenia or whatever (and also, what about weight gain caused by these medications? Isn't this also potentially discriminatory as it could discourage those with mental/emotional issues to cease taking medication in order to get more benefits). I assume they have provisions for pregnant women and women post-pregnancy (if I have trouble losing the baby weight, should I be penalized in the same way as if I was always "overweight?") but then that's requiring people to make even more medical information available that violates people's right to privacy about these things.

I also think about how when I had an eating disorder what effect being praised for my low BMI would have had on me and how that would have rewarded me for my unhealthy behavior.

As a woman, the idea of anyone policing my body just way too uncomfortably gibes with the ways in which women's bodies are reproductively controlled. I can't see this just being limited to the above use (just a food discount), and it seems to be opening up a door that allows "fat" people to be actively discriminated against even more so than they already are.

I think offering different discounts based on any kind of health measurement is bad, only because it's unfair discrimination. And in this case, they are even abusing their power over their employees to demand such testing from them, from which I'm sure they want the data for some reason of their own, and are only using the scheme to get their hands on it. But getting past the ill morality of screening your employees like that, if we were in a world where you have to do it, I would certainly prefer to keep this scheme they're using.

I think, regardless of health, what people generally prioritize is a better discount, and certainly a good discount for eating Whole Foods is not what's gonna motivate people to become healthier (or in this case, improve their cholesterol, BP and BMI), especially if it means they will lose the discount, but rather the opposite will happen, it will motivate people to acquire whatever stats gets them into the best discount categories. Just because, in my opinion, property is the actual ultimate value that the human being upholds, as Machiavelli said: you can kill a man's father, and he'll get over it with time, but if you take away his house or his woman, he will be your enemy until either one of you dies, in whatever words he did use. I don't think that's a particularly good value, and I wouldn't actively promote it, but I've seen very little to imply that Machiavelli was wrong to say it.

But, anyway, also I disagree with using BMI for any sort of health measurement system, because BMI is just totally meaningless, in fact. But we all know about that, by now...

One of the biggest problems I see with this policy is that "health" (as defined by this chart of biometrics, which, as people before me have explained, are not always indicators of healthiness) is SO CIRCUMSTANTIAL. The capacity to be healthy - to have a lifestyle that promotes mental and physical health, in terms of nutrition, exercise, and stress management - is so often tied to socioeconomic status and the specifics of someone's situation. A college student, for example, who works at Whole Foods for extra income, has free time to exercise, meditate and cook nutritious meals, and is financially supported by her parents is likelier to be "healthier" than, say, a single mom working three jobs to pay the bills and who probably doesn't have the time or energy to eat healthily, quit smoking if she smokes, exercise more if she needs to lose weight, and manage stress more effectively.

I'm not saying that people aren't in control of their lives or the choices they make. I'm not saying that someone with a lot of stressors and demands on his/her time is incapable of losing weight, quitting smoking, etc. But I am saying that putting the same person in two very different conditions could have two very different outcomes, including in terms of that person's health.

While this policy may be economically beneficial for Whole Foods (assuming their biometrics scheme accurately predicts which employees costs more in terms of health care), it also rewards those people who are for being privileged enough to maintain good health - and punishes others for working hard out of need.

I don't smoke tobacco, my blood pressure is 115/70, and my LDL blood pressure is 63. But I'm overweight. No room for me... ;)

I work at a Whole Foods, and they must already be getting quite a lot of feedback from customers about this program, because today they distributed a (very long) list of points people have made calling into question the validity of the program...along with a list of answers that debunk critics' claims. Very frustrating.

Is anyone else reminded of the forced gynecological exams in many sweatshops?

What I find bizarre is that noone has mentioned "Abercrombie & Fitch" yet, who don't employ anyone without great abs and gorgeous faces, to attract customers and project that "healthy", wholesome image. I mean that would at least be an added advantage of trying to make my employees skinny.

If they really wanted their employees to be healthier, why not offer steeper discounts on fresh fruits and veggies or organic, locally grown meat? They could then have much smaller (or no) discounts on the pre-packaged junk food.

Oh yeah, that would make sense and we can't have that in corporate America, can we?

As someone who is supposedly underweight, anything involving BMI ticks me off.

It's true that there's benefits to WF to have healthier employees--aside from insurance costs, hopefully it'll also lead to fewer sick days taken. But this is a shitty way to do it. It's patently unfair, as it automatically benefits someone like myself (non-smoker, high metabolism) more than someone who, say, is trying to quit smoking but can't, or who has a harder time losing weight than I do.

A better idea would be to tie these extra discounts to a program aimed at helping people live healthier lives. That way it would benefit those who are putting the extra effort in, regardless of starting points, as well as actually help keep employees healthier.

I haven't read the comments above yet (will in a minute) but on first impression, I actually think it's quite reasonable to offer bigger discounts to healthier staff members... In a health food store. There is a staff discount for all staff members of 20% already - so staff members are not loosing out by not participating, they are gaining from having low blood pressure, not smoking and low cholestrol. I think that's fair enough, whatever about BMI. And staff are *not* obliged to take part (I wonder if there's an opt out option).

I've read over and over in the comments on this site about how obesity is not necessarily linked to bad health - how it's our biases which lead us to judge fat people as unhealthy. No, I can't look at some who is fat and accurately judge if they are healthy or not. But in combination with the other measures, BMI is probably a fairly good indication. And the BMI requirement is not excessive. In fact, to qualify for 30% discount you need only have 1% less body mass than highest point in the BMI range (18-25), and to qualify for the bronze you can be technically obese. So I don't think using BMI here is unreasonable.

(sits back and waits for haters relieving their giant squids of anger...)

I will say that it'll probably be easier for younger staff members to get this discount than older ones. In that sense, it might be biased. I do think in the long run, this could turn out for the best for the company and its staff.

Everyone is talking about the BMI here (and yes I think it's bullshit) - but I'm surprised no one is mentioning the smoker vs. non-smoker category.

Smokers are today's "Rude Citizens Who Should Know Better." And while I don't deny that tobacco products negatively affect one's health, and that in an incentive program designed around health issues it's perfectly reasonable to consider smoking habits as a single indicator of health among many, I think it's striking that there's simply a yes/no division. All other measures here have quantitative values (you must have a certain BMI, blood pressure level, etc) but for a smoker, it's entirely subjective. You do, or you don't; there's no in-between.

There are a million different types of "occasional" smokers. They take a whole month to smoke a pack or two; they only bum occasional smokes off their friends in social situations; they only smoke when they're drinking; they don't smoke cigarettes or cigars but they smoke weed several times a week; they might lace that weed with a little tobacco, which is a perfectly common custom even for potsmokers that don't otherwise smoke tobacco.

So shouldn't this program (at least at the bronze level) have a "sometimes smoker" category? A person with a high-ish cholestorol and blood pressure level, and a BMI of 30, would qualify for the bronze program but only if they never, ever smoke. At all.

I think this really stresses how much "smoker/non-smoker" is a matter of identity. It's assumed that you either do it or don't, and that there is no in-between. Here's an analogy that highlights this problem: Substitute "smoker" with "drinker." What is a "non-drinker?" How often must one drink to be a "drinker?" A glass of wine a day? No booze during the week but some heavy drinking on the weekends? Like drinking, smoking isn't so black & white, and I think it's unfair that a person who smokes on occasion probably wouldn't qualify for this "bronze" program.

Furthermore, why stop at smoking? Does this category include pot use and other drugs? Why isn't the alcohol one consumes taken into account? I would say that a person with a very heavy drinking or cocaine problem is probably less "healthy," so to speak, than a person who smokes a pack a day, but there's nothing in these criteria to reflect alcohol or drug abuse.

Finally, let's go even further and say, why stop at toxins and bodily chemistry? If we're looking at smoking, which is defined solely by habit and not all by bodily chemistry (I assume; maybe there's a "blood tobacco level" or something that they measure, but I doubt it, given the yes/no dichotomy in their chart) then why not have a rule about how much excercise one gets in a given week? How balanced one's diet is?

My general point is this: The whole program is the "health police" that is entirely based on socially constructed ideas around what is and isn't healthy, as many people have already pointed out. BMI is a flawed measure of health at best, and a fatphobic marketing ploy used by the diet industry at worst; cholesterol and blood pressure levels are proper measures of health in theory, but they can be affected by one's natural metabolism and medical conditions like diabetes or poor thyroid control; smoking isn't just a simple "yes I do/no I don't" matter for many people; and there are behaviours much more medically dangerous than smoking that are left out of this. Whole Foods has defined its own idea of health, and used it to qualify the lifestyles of its employees; I'm going to echo Ella's comment above that is truly disturbing how much our culture grants this type of employer intrusion into our daily life. (No, it doesn't matter that the program is voluntary, and in fact if people willingly enter into such an incentive program, I think that emphasizes the allowance of intrusion here.)

I could have easily qualified for the Platinum level discount during my crystal meth days.